Lt. Col. Bree "B" Fram left a doctor's office on April 2. Presenting that day as Bryan, the name given to them at birth, B should have been relieved.

"Overall, it's a good thing," said B. "It just didn't feel great to have to do it on someone else's timeline other than my own."

"It" was an official diagnosis of gender dysphoria. As a transgender member of the military, B had to secure the diagnosis by April 12 in order to continue serving openly.

That's when the Trump administration's new policy on transgender military service takes effect. It effectively bans transgender people from joining the military. The more than 14,000 already serving will be allowed to do so openly, so long as they have that formal diagnosis of gender dysphoria filed by the deadline. If not, they must serve under the gender assigned them at birth - or leave the armed forces.

President Trump first announced the ban in July 2017.

After consultation with my Generals and military experts, please be advised that the United States Government will not accept or allow......

B, who is in the Air Force, met that deadline when a civilian doctor in Ithaca, New York secured their diagnosis. But B's personal journey of identity — shared with their wife Peg — is far from finished.

"I realize that I'm scared," Peg said. "It's accelerated everything so quickly...all of a sudden, we're being forced to make this choice that I don't think we were quite at yet."

B says that language, specifically the term "distressed," was a major disincentive in deciding whether to get the diagnosis — that the idea of having such a medical designation in their employment file is painful, especially when being transgender has never affected their job performance.

And for Peg, making the diagnosis official at this point was unwelcome. She just wasn't ready.

"I have my own journey to deal with," she says. "I met Bryan. I fell in love with Bryan. I married Bryan. We had kids. We moved on. Bree has come into our lives but it's almost like bringing a new person in. It challenges everything from my sexuality to my femininity. And that is a hard thing for me to deal with on a daily basis, let alone have someone come up to me and say 'deal with it faster.' "

Not that Peg isn't grateful that the diagnosis came through, mere days before the deadline. She remembers what it was like to live what she calls an "edited life" before the Obama administration announced it would allow transgender people in the military in 2016.

They have two kids, six and ten, who see their dad's gender identity as "business as usual." But Peg says the family spent years hiding B's gender dysphoria, afraid it would destroy their military career.

B remembers, too — and doesn't want transgender troops who missed the deadline, current and future, to go through that. A week after the doctor's appointment, the Fram family traveled to Washington so B could meet with members of Congress and talk about the Trump administration's ban. B told lawmakers how much harder it is to serve when forced to stay in the closet...or, in the case of those who don't get the diagnosis in time, forced back into the closet.

In contrast, when allowed to serve openly, B says:

"You don't have to have this filter in your brain that has to sit between your thoughts and the words or actions that come out of you...you can reach your full potential."

So why not take that potential elsewhere? Leave the military for a job where the policy doesn't affect B and their family?

"I have so much invested in the military," says B. "The reasons why I joined haven't changed...I joined right after September 11th. That had a profound impact on me and my ability to give back," adding that the military is where they found purpose.

That's what's at stake for the service members who didn't manage to get a diagnosis in time. B works with SPART*A, an organization that represents active duty transgender service members. The group was working with several people trying to file their paperwork up until the last minute.

Delays took many forms, particularly for those serving remotely where military doctors are not available. Even if a soldier gets a diagnosis from a civilian doctor, the paperwork needs a signature from a military medical professional.

And that paperwork itself raises other concerns for the Frams. Having lived through several policy changes as a military spouse, Peg is wary of how the documentation of B's gender dysphoria might be used in the future.

"It opened up another avenue of fear for me," says Peg. "Now that they've been forced to go into this box, it's easier to call them out later."

"The fear is always that this is the tip of the iceberg," says B, believing the current policy is already a social step backward. "What comes next?"

Selena Simmons-Duffin edited this story for broadcast.

Copyright 2020 NPR. To see more, visit https://www.npr.org.

ARI SHAPIRO, HOST:

Tomorrow is the deadline for transgender members of the military to get an official diagnosis of gender dysphoria. Anyone who doesn't make the deadline will have to serve under the gender he or she was assigned at birth or leave the military.

AILSA CHANG, HOST:

Since President Trump first tweeted the trans military ban back in July 2017, we have heard from analysts and government officials.

(SOUNDBITE OF ARCHIVED RECORDING)

SARAH SANDERS: ...That it erodes military readiness and unit cohesion.

CHANG: We've heard from trans service members and trans recruits.

(SOUNDBITE OF ARCHIVED BROADCAST)

NICOLAS TALBOTT: ...Sort of thing. But my purpose is to put on that uniform and do my job and serve my country.

CHANG: Well, today, we're going to hear from a family.

KATHRYN: Hello.

CHANG: You talk right in here.

ALIVYA: Hi.

CHANG: That's Livy (ph). She's 6. She and her 10-year-old sister, Kathryn, were checking out some microphones in the studio here at NPR.

Can you hear yourself?

KATHRYN: Yeah.

CHANG: Yeah.

KATHRYN: It sounds so weird.

CHANG: Right?

Their parents are B and Peg Fram. They live in Ithaca, N.Y., but the family came to Washington, D.C., this week so we could talk to lawmakers about this deadline for trans service members.

LIEUTENANT COLONEL B FRAM: I have an email from the Air Force saying exempt from the policy as it currently exists.

CHANG: B is trans, in the Air Force and leading cyberspace in warfare operations.

B FRAM: I have a couple of different teams working for me to do offensive cyberspace as well as counter drone research.

CHANG: B has been married to Peg for 14 years.

PEG FRAM: We are the backbone, I really feel, that makes the military member able to do what they can do, when they have someone supporting them, loving them. We do our own type of service as a military family.

CHANG: Early on in their relationship, B, who uses they-then pronouns, told Peg about wrestling with their gender identity.

B FRAM: I communicated these feelings that I'm in some way different to her within three weeks of us having met. But I didn't know what it meant at the time. So it's been a roller coaster a bit between us in, what does this mean? How does this impact our relationship?

CHANG: All of that was going on at home, and it was a secret.

B FRAM: You'd have to stop and think, oh, if I say this and it gets in the wrong ear, does it come back to me and I lose my career for something that has absolutely nothing to do with my ability to perform?

P FRAM: I used to say I lived an edited life. I had to stop and think and switch pronouns in my head and basically lie sometimes.

CHANG: In 2016, that changed. The Obama administration announced transgender people were welcome in the military. They could come out, receive medical care and get treatment covered by their government benefits.

B FRAM: The ability to serve openly is an amazing one because you can bring your whole self to work.

P FRAM: It was such a huge relief and a weight off my shoulders to not have to edit everything that I said anymore. But then, on the other hand, I am by far more private about things like this...

CHANG: Than B is.

P FRAM: ...Than B is. So B and me, it was like, all right. Let's do this.

CHANG: (Laughter).

P FRAM: Let's go out there.

B FRAM: Let's change some hearts and minds.

CHANG: (Laughter).

P FRAM: And meanwhile, I'm like, let's chat, and let's help people individually.

CHANG: Well, now there's a new administration and a new reality. B is openly trans at work, and the only way they could continue to work, serve and continue to be out was to get an official diagnosis of gender dysphoria. Getting that diagnosis in hand is what allowed B to get that email from the Air Force exempting them from the ban. But the decision to rush and get that diagnosis was not an easy one.

B FRAM: Being put on the clock was awful. It's an imperfect analogy, but I like to talk a little bit about being trans as it's kind of like having high cholesterol, where if you reach a certain threshold, you need treatment. Some people don't reach that stage until later, and some people never get there.

But I was put on a clock when said, you need to make the decision right now about where you might be in the future. And if you don't make that decision now and you get to that point, you would be forbidden from seeking treatment for it even if your doctor says it's medically necessary care. So that was a brutal feeling to be stuck on the clock.

CHANG: Peg, what about you? I mean, what has it been like trying to meet this April 12 deadline for you personally?

P FRAM: Short answer, it hasn't been easy. We've struggled throughout our entire relationship with how far is comfortable for us right now? Is going out on dates comfortable for us or not? And it's kind of a give-and-take. And then to have someone else tell me, no, no. You need to accept this. Everything in me fought against that because I just wanted to say, no, you don't get to tell me what I get to do.

I have my own journey in dealing with - I met Bryan. I fell in love with Bryan. I married Bryan. We had kids. We moved on, and B has come into our lives. But it is almost like bringing a new person in.

CHANG: Right.

P FRAM: It challenges everything from my sexuality to my femininity, and that is a hard thing for me to deal with, let alone to have someone come up and say, deal with it faster.

CHANG: Right. It is official now, right?

B FRAM: It is.

CHANG: This is on a piece of paper. How does seeing that piece of paper or that email make you feel, Peg?

P FRAM: I'm still scared.

CHANG: Why?

P FRAM: I'm scared that now it's easier for someone to come through later on and change the policy and say, we've called you out. We have this piece of paper that says that you have gender dysphoria, and we don't like that. So anybody with that in their record is now gone - not saying that they will, but it opened up another avenue of fear for me.

CHANG: Do you share those fears, B?

B FRAM: Not that specific fear, but what held me back for the longest time from getting the diagnosis is you must have clinically significant distress. And the thought of going to someone saying, you're clinically distressed and in some way incapable of doing something was really painful 'cause it never affected my ability to do my job in any way. But having that on a medical record is still scary.

CHANG: What about your kids? How are they absorbing this?

B FRAM: We haven't shared anything medically with the kids. To the kids, it's just business as usual.

CHANG: Yeah.

P FRAM: Because this is what they've known for the majority of their lives, and they've learned to accept that and integrate it into their lives. It's not so easy for people on the outside who haven't lived this.

CHANG: Yeah. Peg, you know, you were saying how you're the more private one. You're not the one who's going to put yourself out there and be out there. But you're out here in Washington, talking to lawmakers. You're here sitting in front of me on mic. In a way, has this deadline given you the ability to own it?

P FRAM: It has. I'm standing here saying to everyone, listen, B is our primary breadwinner. I gave up my career accepting that we were going to be part of the military for 20, 30 years. I want people to understand that the spouses, the children, all of us are here and being massively affected by this ban. And if that means that I come out, and I'm the one who stands up and is able to talk about it, then I will step forward. And I will do it because I think it is so important.

CHANG: B, I'm sure there are a lot of people listening who would say, if you're so upset about this deadline and the pressure that you've been placed under, why don't you just leave the military?

B FRAM: I have so much invested in the military. The reasons I joined haven't changed. I joined because I want to serve my country, and I want to keep our men and women around the world safe. And that's what I've done through my entire career in the development of technologies and capabilities that watch over us.

I joined right after September 11, and that had a profound impact on me and my ability to give back. The military is where I found a home. It's where I found a family. It's where I found purpose, and I want to remain a part of that.

CHANG: Lieutenant Colonel Bryan Bree Fram and Peg Fram, thank you both for coming in and spending the time to talk to us today.